Major US funding boost for trial of sugar gel for newborns

Major US funding boost for NZ-Aus trial of sugar gel for newborns

New Zealand-led research that could improve the care of up to a third of all babies born and potentially prevent brain damage in infancy has received a $2.8 million boost from the United States.

The funding is for research underway at hospitals in Aotearoa New Zealand and Australia investigating whether a dextrose (sugar) gel could prevent a common, potentially serious condition in newborns.

The grant of US$1,968,326 over five years comes from the National Institutes of Health, the main agency of the US government responsible for biomedical and public health research.

The study is led by Distinguished Professor Jane Harding from the University of Auckland-based Liggins Institute. She says it is highly unusual for a New Zealand study that is not part of a US-based collaboration to receive this grant.

“This shows how unique and important this research is. We are delighted because this will allow us to be sure we can finish the study, including the follow-up.”

The study, dubbed hPOD, involves rubbing either the sugar gel, or a placebo, into the inside cheeks of at-risk newborns an hour after birth. Researchers believe the inexpensive gel could prevent them from getting a common condition called neonatal hypoglycaemia (low blood sugar) - the only readily preventable cause of brain damage in infancy. (hPOD stands for hypoglycaemia Prevention with Oral Dextrose.)

Neonatal hypoglycaemia affects one in six babies. Left untreated, it can cause developmental delay, brain damage and lowered education outcomes later in life. The ground-breaking 2013 “Sugar Babies Study”, also led by Professor Harding, a preeminent New Zealand paediatrician, showed the sugar gel works as a treatment for low blood sugar, and it is now widely used in Aotearoa and a growing number of other countries, including the UK, Australia, and the US.

“We thought if it works well to treat babies with low blood sugar, could we use it to prevent babies getting low blood sugars?” she says. “If we could do that, we might reduce the number of blood tests they need, reduce the amount of angst that families experience, and potentially even prevent brain damage.”

Low blood sugar often means babies have to go into an intensive or special care unit, separating mother and baby just as they are trying to establish breastfeeding. Currently, there is no proven preventative, and many at-risk newborns are given formula, which can also disrupt breastfeeding.

At-risk babies – up to a third of all born - are those born preterm, smaller or larger than usual, and babies whose mothers have diabetes.

The research team tracked some of the babies from 2013 Sugar Babies Study. They found that children who had experienced low blood sugar as newborns were two to three times more likely to have difficulties with executive function (skills for problem-solving, planning, memory and attention) and visual-motor co-ordination (skills for fine control of movement, and understanding what you see) at age 4.5 years than children who had normal blood sugar levels. Strikingly, children who had experienced a drop in blood sugar not detected by routine blood sugar monitoring were four times more likely to have difficulties with these skills.

“This shows that even brief periods of slightly low blood sugar are associated with increased difficulties at 4.5 years, so finding a preventative may well be important,” says Professor Harding.

The hPOD trial is about halfway towards its target of 2129 newborns, and is being run at: Auckland City Hospital, North Shore Hospital, Whangarei Hospital, Waikato Hospital, Tauranga Hospital, Hawkes Bay Hospital, Whakatane Hospital, Southland Hospital, and five Australian hospitals.

Pregnant women interested in finding out more can visit the hPOD study page, or email hPOD@auckland.ac.nz. Watch this video clip of Professor Harding talking about hPOD.

Other funders are the Health Research Council, CureKids, Lottery Health and the Waikato Medical Research Foundation.

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